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Research shows survivors’ sexual fantasies largely overlap with those of non-victims.

Sexual responses after trauma vary widely, including both decreased and increased engagement.

Supportive partners and clear communication help create positive sexual experiences for trauma survivors.

When discussing sexual trauma in professional therapy articles, conferences, or media catering to the general public, it is presented solely on what has been lost by survivors, i.e., sexual desire, erotic excitement, or a sense of embodiment and pleasure in one’s body. While these sexual symptoms are described frequently in sex therapy by sexual trauma survivors, they are only part of the broad array of sexual and erotic experiences that survivors can heal from and gain agency over time in sexual trauma-focused somatic sex therapy treatment.

In both clinical work and in new studies, many sexual trauma survivors report more hopeful outcomes around their partnered and solo sexuality. Many learn that the responses they express during partnered sex fall into one of the four Fs of trauma responses, namely: fight, flight, fear, and fawn. While many survivors do struggle with avoidance of any partnered sex—pushing partners away when triggered, or a pattern of disassociation during sex—others continue to experience desire and curiosity for partnered intimacy. Consequently, not all survivors of sexual trauma respond the same way to erotic and sexual experiences, and their sexual experiences are not always devoid of pleasure.

This brings up an important question: What actually happens to sexual pleasure and fantasy life after sexual trauma, and what does sexual healing actually entail?

What Kinds of Sexual Fantasies Do Trauma Survivors Actually Have?

In a recent 2024 study in the Journal of Child Sexual Abuse, Canivet and his colleagues examined sexual fantasies among 48 adult survivors of childhood sexual abuse (CSA) and 44 non-victims, all living in North America. The researchers identified 10 categories of fantasies, including romantic connection, group sex, and emotional needs like sexual validation. Interestingly, the most common fantasies amongst the two groups were strikingly similar. In both groups, genital stimulation and oral interactions were the most popular fantasies. These were followed by two fantasy categories equally chosen by both survivors and non-victims:

Desires and imagery about being cared for

Contrary to what the public may think, when looking at overall patterns, most fantasy categories were reported equally by survivors and non-victims, with nine of the 10 categories reported in both groups.

Even themes often mistakenly associated solely with trauma by the general public and many general therapists, like submission/masochism and violence, were reported by individuals without a history of sexual abuse. This finding challenges the idea that survivors’ fantasies are inherently different or defined primarily by power dynamics or past experiences.

The one category that Canivet and their team found unique to survivors might be surprising: versatility. This fantasy focuses on the “openness to fully explore and embrace the diverse roles within sexual power dynamics." When clients in sex therapy are asked about their fantasies they’d like to experience, they frequently describe their desires to enact roles in both the submission and dominance realms of power exchange. Some describe sexual behaviors associated with BDSM (bondage, discipline, sadism/masochism) while also expressing to the clinician that they feel shame after watching these kinds of scenes in porn or experiencing them consensually with a partner.

For some survivors, kink fantasies may serve as a way of gaining mastery over the past traumatic experiences by shifting the dynamics of what once felt out of control into full control within their agency. The wide range of fantasies in this study stressed that most survivors did not report fantasies that included violence or sadism.

This study supports the critical finding that sexual fantasy exploration by trauma survivors is more diverse, individual, and not defined by any single pattern.

Sexual Behaviors Experienced by Survivors Vary Widely

The variability in fantasy life is illustrated in survivors’ lived sexual experiences as well. In a qualitative study published in 2018 in the Journal of Sexual Research, O’Callaghan et al. conducted in-depth interviews with 45 adult female sexual assault survivors and 45 of their informal support providers (partners, family members, etc.) who were not survivors, with interviews taking place on average about 12 years after the assault.

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Rather than finding one consistent pattern in their sexual responses, the study found a wide range of behaviors in survivors’ sex lives. Some trauma survivors became more sexually active by taking more than one sexual partner, while others leaned towards sexual abstinence.

Notably, none of the survivors described having an explicit fear of sex.

Instead, many describe a loss of interest, often due to past repeated victimization in sexual encounters or relationships. These are the clients who self-refer to sex therapy with the presenting problem of having a low libido. This is a problem that is causing rifts with their partner or making them feel like they’re missing out on what could be more pleasure in their sex life.

In O’Callaghan’s study, many participants described having positive sexual experiences in romantic relationships, especially when their partners were communicative, respectful, and attentive to their boundaries. Some partners adjusted their approach to intimacy by moving more slowly and asking for consent more explicitly. For example, one participant verbalized to their partner: “If oral sex bothers you, we don’t have to do it. We’ll just go at your own pace."

Sex therapy helps survivors and their partners in couples treatment to learn new verbal scripts like those stated in the study to engage more confidently and safely with partners. It also teaches survivors to recognize when they are being triggered and/or disassociating and asking their partners to stop and pause the sexual activity. This break allows them the space to do grounding and breathing techniques to reconnect with their body and lower the impact of the trauma symptoms. These skills allow a survivor to slow the pace of a sexual encounter so they can engage with a partner who can support their growing sense of safety and agency.

While challenges such as triggers or mismatched desire are common symptoms among survivors in sex therapy, this study shows that sexual experiences after sexual trauma are not defined solely by avoidance or disconnection. They can also include connection, safety, and sexual pleasure.

What Sexual Trauma Sex Therapy Provides

According to a 2013 Journal of Sexual Medicine study and clinical experience, sexual trauma survivors benefit from actively engaging in healing through a variety of healing modalities, including:

Individual sex and trauma psychotherapy

Creative outlets, like art therapy or dance classes

Both the research and clinical techniques described in this post focus on a sexual assault survivor of any gender or orientation developing a more intentional, self-defined relationship with their own sexual pleasure. Through sex therapy, survivors learn communication skills, techniques to decrease levels of shame, grounding exercises, and gain accurate education about the wide spectrum of authentic fantasy and sexuality. These interventions open up the wide possibilities of pleasurable sexual behaviors that are consensual, more aligned with their fantasies, and less constrained by trauma triggers and self-limiting beliefs.

To find a therapist, visit the Psychology Today Therapy Directory.

Canivet, C., Lafortune, D., Bolduc, R., & Godbout, N. (2024). A qualitative analysis of sexual fantasies among childhood sexual abuse survivors and Non-Victims. Journal of Child Sexual Abuse, 33(8), 970–986. https://doi.org/10.1080/10538712.2024.2415553

Daglieri, T., & Andelloux, M. (2013). Sexuality and sexual pleasure after sexual assault. The Journal of Sexual Medicine, 10(10), 2611–2612. https://doi.org/10.1111/jsm.12317

O’Callaghan, E., Shepp, V., Ullman, S. E., & Kirkner, A. (2018). Navigating sex and sexuality after sexual assault: A qualitative study of survivors and informal support providers. The Journal of Sex Research, 56(8), 1045–1057. https://doi.org/10.1080/00224499.2018.1506731

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